Evergreen Group Home
NPI #1841452109 in Urbana, Missouri
Provider Information
- NPI Number
- 1841452109
- Entity Type
- Organization
- Organization Name
- Evergreen Group Home
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Jun 27, 2008
- Last Updated
- Jun 27, 2008
Practice Location
Authorized Official
- Name
- MR. GARY D BOGGS
- Title
- DIRECTOR
- Phone
- (417) 722-4416
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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